PRP for TE

I had my Platelet Rich Plasma treament on Wednesday and it was pretty
much as I expected.

The Doc drew a fairly small amount of blood from my left arm and gave it to
the assistant to process, which took about 15 minutes. What was left was
maybe 1 cc of concentrated platelet. After numbing my wrist and elbow with
some lydocaine the procedure began. Using 2" long (but small dia.) needle
the Doc started with my elbow. I only looked once or twice so its kinda hard
to tell how many times he stuck me but it was a lot. I guess 25 or 30 . But
with some of that he just partially withdrew the needle and moved it around,
tracking down the tendon. I could feel my wrist swelling from the elbow
injections! But appearantly that was normal. This took about 3 minutes but
seemed much longer. I didn't really feel pain just uncomfortable as that long
needle plunged deep into the elbow.

Nest came the wrist and this was no fun. For this the Doc used a floroscope
to guide the injection. I could see the moniter and saw the needle move in
and out between all those wrist bones, pretty graphic. The wrist was done
in another 2 or 3 minutes and it was all over.

The Doc told me I would be cussing him on the way home and he was right.
It hurt. A lot. My arm was swollen, throbbing and felt like it weighed 50 pounds. I couldn't lift it.

Needless to say I found my way to the first drug store and got my presc. for
hydrocodone filled. In another 45 minutes or so I was ok.

When the first pill wore off the pain wasn't nearly as bad, so I waited until
bedtime to take another. Today, Thursday the pain is pretty much gone but
my arm is very stiff. I haven't needed anymore pills.

As far as effectiveness on TE, we will just have to wait and see. The Doc
says it will be in the 3rd week or so to get any idea how much progress has
been made, but he expects good results. He's pretty sure one treatment
will fix the elbow but the wrist is just wait and see. He also told me to
lay off the racquet for one month if I wanted max benifet from the procedure.

Sometime around week 3 I will begin light stretching and very light dumbells.
This seems to be a little on he conservative side according to what I have
read but I would rather err that way then rush it. The Doc had already done
4 PRP's before I got there Wed at 11am.

I'll update as needed, and hopefully this will turn out to be an effective CURE
for TE. And in case someone hasn't read my other posts , Yes I have tried almost every treatment you ever saw listed on the forum. They didn't work.

Can't wait to hear the results. BTW, 25 - 30 injections of a total of 1cc sounds interesting. 1/30 of a cc is pretty darn small, probably much smaller than the amount of serum that was left in the barrel of the needle.

The insurance lady at the doctors office told me that most insurance has
paid for this procedure. My insurance pre-approved it but I have no idea
how much they will end up paying. I also have supplemental ins which should
pay some too. The cost for one treatment is around $ 1000. There are some
clinics around the country that specialize in this where you can get an
elbow done for $ 500- $600, but none were close enough to me. Its probably
gonna end up costing me some but I'd rather make a few payments then
miss tennis all summer, if it works.

Zac, this Doc is in Huntersville if you're ever interested, I didn't know what
part of the state you were from.

The one cc was just an estimate, I have little medical knowledge and I am
not familiar with syringes. But the amount given at any one point IS very ,
very small. He barely moved the plunger.

Today, 2 days post procedure I have no pain just stiffness left and that seems to be working out pretty fast.

I've had wrist and TE a little over 3 months. It started with the wrist, the TE
came on one day when I wore a wrist brace to play for the first and only time, it only took 2 sets to get TE. I went from a perfectly fine elbow to full
blown TE in 2 sets!

Today , 4 days after the procedure I am still a little tight in the forearm but
less than yesterday. I HAVE NO PAIN IN MY ELBOW! What would happen if I
picked up a racquet I don't know, but I'm not gonna do that.
My wrist feels strong but I do get an occasional phantom pain that comes out
of nowhere , last for maybe half a second and then is gone. This usually happens when I'm not even moving it. No big deal. And also the doc is not sure that I don't have a cyst in my wrist that will still have to be dealt with.

From what I've read this initial pain relief is mostly from fresh blood being
attracted to the injury sites. It will still be 2 more weeks or so when I start
working these areas to really see how they hold up now, but for now all looks
good.

Oh, I am 52 and prior to this injury I was playing at least 3 or 4 day a week,
including a couple long sessions on my ball machine plus a couple hundred
serves. I had kept this up for about a year and a half with no problem at all.
I had played with a K95 and then a Aero Pro Drive, but my problem with the
wrist started almost immediatly when I got a Pure Drive 107, ( very stiff)

Ironically, I was playing much better with the 107. When I come back I'm
looking at either a Volkl C10 Pro or Microgel Radical OS.

sounds good man i hope u can get back 2 it quick....on a side note,i really dont feel like ice and anti- imflammatories are the answer to this problem ,but more an initial rest >stretching/massage>strengthen>ease back into tennis with the right quipment.....just my opinion from my experience
were u using poly?

I was using a poly/gut hybrid. I only tried full poly one time for about 20
minutes and then cut it out of the frame, way too harsh for me.

Most of the current thought on TE is that it is not an inflammation at all but
a degenerative process. Not only do ice and anti-inflams not help, they may
actually interfere with the healing process. The worst of course being
cortisone. I think many cases of TE can be overcome with time away from
tennis and rehab, I had a case in my 20's and it basically forced me out of
tennis for years. Only after I was married and bored did I remember I once
played the game and started back playing. By this time my elbow was fine.

On the other hand 2 guys I know have been fighting tennis elbow for 3 or
4 YEARS! They wear elbow braces, constantly take anti-inflams and ice after
playing. But they haven't got any better.

Of all the things I tried before PRP I think Active Release and Graston Therapy
are beneficial. They may even cure some milder cases. Even if the PRP cures
my TE I will probably still go back every few months for ART and GT, it does
relax your arm.

PRP is the only biologic treatment available so to me it was worth a try, I just
can't bear the thought of sitting out for many months. Anyways, update for
today 6 days post procedure: minor stiffness remains in forearm (less than
yesterday) minor discomfort ( not pain) in wrist when flexing, elbow will
lockout now with a little assistance and shows no pain when doing so.

I was told 2 weeks to get back to baseline pain, I have to believe I'm way
ahead of that.

I was using a poly/gut hybrid. I only tried full poly one time for about 20
minutes and then cut it out of the frame, way too harsh for me.

Most of the current thought on TE is that it is not an inflammation at all but
a degenerative process. Not only do ice and anti-inflams not help, they may
actually interfere with the healing process. The worst of course being
cortisone. I think many cases of TE can be overcome with time away from
tennis and rehab, I had a case in my 20's and it basically forced me out of
tennis for years. Only after I was married and bored did I remember I once
played the game and started back playing. By this time my elbow was fine.

On the other hand 2 guys I know have been fighting tennis elbow for 3 or
4 YEARS! They wear elbow braces, constantly take anti-inflams and ice after
playing. But they haven't got any better.

Of all the things I tried before PRP I think Active Release and Graston Therapy
are beneficial. They may even cure some milder cases. Even if the PRP cures
my TE I will probably still go back every few months for ART and GT, it does
relax your arm.

PRP is the only biologic treatment available so to me it was worth a try, I just
can't bear the thought of sitting out for many months. Anyways, update for
today 6 days post procedure: minor stiffness remains in forearm (less than
yesterday) minor discomfort ( not pain) in wrist when flexing, elbow will
lockout now with a little assistance and shows no pain when doing so.

I was told 2 weeks to get back to baseline pain, I have to believe I'm way
ahead of that.

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Don't confuse injury with pain. They can be two very different things...

I went for my one month follow up visit today and the doc gave me the
ok to resume tennis on a limited basis. I can start working with light
dumbells and hit every other day or so.

I am supposed to go easy, no hard hitting or matches, progressing to
heavier weights and harder hitting for each of the next 4 weeks. At that
point if I'm satisfied then fine if not then one more treatment might be
in order.

Right now I only have a little stiffness in my forearm, and I'm told this is
normal but should work out through the weights and tennis.

Just checking in 5 weeks and one day after the procedure. I hit for about
an hour 3 times this week and it was absolutely pain free! There was minor
stiffness in my forearm muscles the next morning but it goes away once
I start moving. I also lifted weights 3 times this week.

I plan on maybe playing a set or two this weekend.

I won't continue this thread unless anyone has questions but just so everyone
knows I went from severe wrist pain and TE to playing absolutely pain free
in 5 weeks. I have to believe this is the best thing going for TE.

Thanks for the updates. Just got my first bout w/ TE and have laid off hitting for 3 difficult weeks. Pls keep us posted w/ your progress. Hope you're cured for good. Which racket/tension are you using?

For me, I have been suffering from TE for 2 1/2 years by now and have gotten 2 cortisone shots.

I then had 2 PRP injections twice 6 mths apart a year after my second cortisone jab.

But sad to say the PRP did nothing for me. Till today, my elbow still feels a dull ache when I grip the racket with my arm straightened.

So bottom line is PRP does not work for everyone.........

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Sorry to hear that, no medical procedure is 100%. A lot of factors to consider, severity of injury, skill of doctor, and one's own ability to heal.
If all you are feeling is a dull ache you might want to consider one more
round of PRP. My doc told me most elbows respond within 1-2 injections,
but other body parts have taken several more. There's always going to
be exceptions but the only formal study I found showed that 93% were
satisfied with PRP for TE.

If my arm hurt for a year and nothing else worked I wouldn't hesitate to
go for surgery.

Sorry to hear that, no medical procedure is 100%. A lot of factors to consider, severity of injury, skill of doctor, and one's own ability to heal.
If all you are feeling is a dull ache you might want to consider one more
round of PRP. My doc told me most elbows respond within 1-2 injections,
but other body parts have taken several more. There's always going to
be exceptions but the only formal study I found showed that 93% were
satisfied with PRP for TE.

If my arm hurt for a year and nothing else worked I wouldn't hesitate to
go for surgery.

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Well I guess PRP works better if you've not gotten cortisone jabs before. Somehow the cortisone has done some irreparable damage to my elbow tendons.

Not too sure about surgery though as I've heard so many stories that once you go under the knife, you may never get back the same mobility in your elbow. Anyone here has any success stories to share on elbow surgery? I would definitely feel more encouraged to undergo surgery if chances of playing pain free after surgery is good.

Otherwise, I guess I'll sit out for another year without tennis and see if my elbow pain will miraculously disappear........

awesome robb ! if u can go a cpl months without pain id like to know about it and how much did the procedure cost u b4 and after insurance if u dont mind me asking

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I think the doc billed the insurance $1080. I don't know what the final
bill to me will be because I am still dealing with the insurance company.

I have Wellpath which is the sorriest insurance on the planet, but I knew that
going in. The insurance lady at the docs office said they have never had a
problem getting any insurance to pay Except Wellpath. Even if I have to give
the doc $100 a month to pay off the balance it would be worth it.

Glad you are doing so well. I've been watching your thread to evaluate your success. I have a doubles partner who needs the procedure but he can't find anyone in GA offering the procedure. Can you email me the name of your clinic and doctor in Huntsville?

I sent you an email. You might do a search at the above address, a lot of
docs who were doing prolotherapy are starting to do PRP. There are bound
to be docs in Atlanta doing this procedure.

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I was really intrigued by the idea of PRP until the link to prolotherapy came up. Prolo seems very fringe and orthopedists I've seen who are very open to alternative therapies such as shockwave (which worked great for me) think prolotherapy is quackery...

I was really intrigued by the idea of PRP until the link to prolotherapy came up. Prolo seems very fringe and orthopedists I've seen who are very open to alternative therapies such as shockwave (which worked great for me) think prolotherapy is quackery...

Are there any decent studies yet on PRP?

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Maybe they are not as open as you think. My doc is an orthopedic surgeon
specializing in sports medicine and he does both PRP and prolo. I have seen
more than a few docs who discourage anything that would keep them out
of the operating room and the big $$$$$.

There are studies out and more major studies are underway nationwide.
Just do a search for " prp tennis elbow "